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Background The use of virtual simulation methods in nursing education offers potential advantages for students to experience and learn in a safe and realistic environment by acquiring skills and attitudes to prepare for clinical experiences. Objective The study's aim was to test the hypothesis that nursing students who used a mobile learning app would have significantly (1) higher levels of knowledge about medication administration and nasotracheal suctioning, (2) better development of skill performances on medication administration and nasotracheal suctioning, (3) higher satisfaction, and (4) lower cognitive load than a control group. Design A randomized experimental study with pretest and posttest design. Settings and participants One hundred nursing students were randomly assigned to an experimental or control group at a Southern Taiwan university's school of nursing. Methods The experimental group received the virtual simulation-based mobile learning app and the control group used traditional paper materials. Participants were assessed on knowledge before and after the intervention. Skill performance and intrinsic and extraneous cognitive load were measured after the intervention. Results The experimental group who used the mobile app had significantly higher knowledge scores, significantly lower intrinsic and extraneous cognitive load, better skill performance, and higher satisfaction than the control group. Conclusions The implementation of a mobile app for simulation learning had a positive impact on nursing students’ knowledge and skill performances as well as the reduction of learning cognitive loading. Nurse educators and researchers should collaborate in developing virtual learning resources to support clinical nursing education. Tweetable abstract: The mobile app for learning achieved higher knowledge and satisfaction scores, demonstrated better skill performance without increasing cognitive load.

Nursing is a practice-oriented profession, and the goal of education is to cultivate confidence and assertiveness for future clinical practice. Nurturing a professional self-concept at school is expecting to help students to approach their success in the nursing profession.Using a hierarchical model associated with critical thinking, academic achievement, class climate, and work experience, this longitudinal correlational study explored the growth trajectory of professional self-concept over two years in students attending 2- or 4-year baccalaureate nursing programs.This was a longitudinal and correlational study with five repeated measurements. Questionnaire data were collected by using the Chinese version of the Nurses Self-Concept Instrument (NSCI-C) and the California Critical Thinking Disposition Inventory (CCTDI).Scores for overall professional self-concept ranged from 84.51 (standard deviation [SD] 12.34) when the students began this study to 89.28 (SD 11.23) at graduation. Hierarchical linear modeling yielded the growth trajectory of professional self-concept was significantly associated with time (β = 0.93, p .01), CCTIDI (β = 0.13, p .001), and class climate (β = 5.20, p .01). An intraclass correlation coefficient was 55.48%.This study confirmed the positive growth trajectory of the professional self-concept in the nursing students' two academic years. The continuous development of the professional self-concept of nursing students is encouraged. Development of critical thinking through their studies, feelings of belonging in their classes, and campus culture all contributed to this trend. To construct a comprehensive hierarchical model, future investigations should use large sample sizes from various classes and conduct multisite evaluations.

Background. Existing literature suggests that an association exists between coronary artery disease (CAD) and carpal tunnel syndrome (CTS), but few researchers have explored whether CTS is a risk for CAD. Materials and Methods. This large case-control study explored the association between CTS and CAD, using health insurance claims data from Taiwan’s National Health Insurance Research Database (NHIRD) between January 2000 and December 2013. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes identified 70,622 patients with CAD (ICD-9-CM codes 410–414; cases); 70,622 patients without CAD were frequency-matched by age, sex, and index year of CAD and served as controls. Results. The likelihood of a previous diagnosis of CTS (ICD-9-CM codes 354.0, 354.1) was significantly higher in the CAD group than in the comparison control group (crude OR: 1.75, 95% CI 1.63-1.89; p Conclusion. A significant positive correlation was observed between CAD and a previous diagnosis of CTS.

Nurturing a professional nursing self-concept is crucial in nursing education. To determine whether it has been achieved, a reliable and valid measurement tool is necessary. This study therefore aimed to translate the Nurses Self-Concept Instrument (NSCI), and then ascertain the content and construct validity, and test-retest and internal consistency reliability in the Chinese version of the NSCI (NSCI-C). A methodological design was conducted with 1239 nursing students of a university recruited as the sample frame and 540 randomly selected. The results showed the content validity index of 0.81 overall, alpha of 0.92 overall, and correlation coefficient of 0.87. The mean score of the NSCI-C was significantly higher in freshman than in senior (p.01). The hypothesized four-factor model did not fit the data well. After restructuring, two factors were explored, with 69.04% explained variance. The findings suggest that the NSCI-C is reliable and valid in nursing students.

Winner‐Take‐All (WTA) networks frequently appear in neural networks. They are primarily used for decision making and selection. Maxnet is a WTA network; it can select the maximum from a data set. However, there are two essential drawbacks to the Maxnet. The first drawback is its slow convergent speed if the input data have almost the same values or the amount of input data is very large. The second one is that it fails when nonunique extreme values exist. In this paper, a new WTA network model called Fast Maxnet is proposed to select the maximum from a data set and be able to converge to the correct state in any situation. Simulation results indicate that the fast Maxnet converges much faster than the Maxnet.

Summary Objective This pilot study evaluated whether acupressure affected the postoperative comfort of gastric cancer patients following a subtotal gastrectomy. Methods A randomised controlled trial was conducted. Sixty patients were recruited from 141-bed general surgery ward at a 3000-bed medical centre in Northern Taiwan. Participants were randomly assigned to either a control group receiving regular postoperative care or to the experimental group receiving additional acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days. Results The similarities between two groups were in postoperative pain and the onset of postoperative nausea and vomiting (PONV) at the baseline. Following acupressure, significant differences were found in postoperative pain ( P =.03) and time of first flatus ( P =.04); but not PONV ( P =.49), nor the time of first defecation ( P =.34). Conclusions Acupressure is a simple, noninvasive, safe, and economical procedure for improving the comfort of patients who undergo surgery for gastric cancer. Acupressure at the P6 and ST36 acupoints can improve postoperative comfort by alleviating pain and decreasing the time until first flatus. However, additional research is necessary to elucidate how acupressure can improve postoperative outcomes.

Using data pooled from 15 waves of the Women’s Marriage, Fertility, and Employment Survey, this paper documents trends and educational differentials in marriage formation among Taiwanese women born between 1910 and 1979. Estimates of hazard rates and cumulative probabilities of first marriage show that women born in more recent cohorts married later and less often than those born in earlier cohorts; likewise, more highly educated women tended to marry later and less often than their less educated counterparts. Educational differentials have increased across successive birth cohorts, such that one in four college-educated women born in the 1960s was never married by age 40.

Using data pooled from 15 waves of the Women's Marriage, Fertility, and Employment Survey, documents trends and educational differentials in marriage formation among Taiwanese women born between 1910 and 1979.